Tacrolimus-Associated Guillain-Barre Syndrome

摘要

Guillain-Barre syndrome (GBS) is one of the common causes of acute polyneuropathy in adults affecting approximately 1, 00,000 people every year worldwide. It mainly affects peripheral nerves and is characterized by asymmetrical ascending paralysis; however, areflexia and loss of proprioception can also be present. It is most commonly demyelinating, but there are other variants such as motor or sensorimotor axonal neuropathies. Its most severe complication is acute respiratory failure, which has a mortality rate of 15%-30%. Most of the cases are usually preceded by any immune stimulation or infection that triggers an aberrant autoimmune response damaging peripheral nerves with their spinal roots. Commonly associated infections are respiratory or gastrointestinal infection such as cytomegalovirus (CMV), Campylobacter jejuni, etc.3 It has also been associated with neurotoxicity caused by calcineurin inhibitors. We describe a case of acute GBS in a postrenal transplantation patient associated with tacrolimus.